The National Quality Forum has endorsed four potentially avoidable complication (PAC) measures created by the Health Care Incentives Improvement Institute. According to HCI3, reduction of PACs can improve care and decrease healthcare costs.

HCI3's PACs are already incorporated in PROMETHEUS Payment, the organization's model for healthcare measurement and payment that rewards hospitals and physicians for coordinating and providing high-quality care. The PACs cover acute myocardial infarction (heart attack), pneumonia, stroke and six chronic conditions: diabetes, congestive heart failure, hypertension, chronic obstructive pulmonary disease, asthma and coronary artery disease.

[Find out how NQF is supporting clinical decision support.]

"This endorsement is a significant step forward to creating a payment system that rewards professionals for the quality and efficiency of services, rather than quantity," said Francois de Brantes, executive director for HCI3, a not-for-profit, multi-stakeholder umbrella organization that sponsors Bridges to Excellence and PROMETHEUS Payment. "Potentially avoidable complications consume a tremendous amount of dollars in addition to providing bad outcomes for patients. Our research and pilots show that lowering PACs improves quality and affordability of healthcare."

According to a study by HCI3, PACs account for as much as 30 cents of every dollar in U.S. healthcare spending across six common chronic conditions – asthma, CAD, CHF, COPD, diabetes and hypertension. The study also found wide variation in PAC costs among providers and across the country, suggesting that these costs can be reduced.

"These measures may eventually be adopted by employers to quantify the percentage of dollars they are spending on PACs to create programs with health plans and employees that reduce those costs over time," said de Brantes. "In addition to cost savings, holding providers and plans accountable for reducing PACs has the potential to improve patients' experience with the care they receive."

According to HCI3, the new measures endorsed by NQF are:

• A proportion of patients with a chronic condition that have a potentially avoidable complication during a calendar year;
• A proportion of AMI patients that have a potentially avoidable complication (during the index stay or in the 30-day post-discharge period);
• A proportion of stroke patients that have a potentially avoidable complication (during the index stay or in the 30-day post-discharge period); and
• A proportion of pneumonia patients that have a potentially avoidable complication (during the index stay or in the 30-day post-discharge period).

[See other measures NQF has endorsed.]